Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1216, New York, NY 10029, USA.
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1070, New York, NY 10029, USA.
Int J Environ Res Public Health. 2022 Jan 25;19(3):1311. doi: 10.3390/ijerph19031311.
As the locus of long-term care in the United States shifts from institutions to the community, paid caregivers (i.e., home health aides, personal care attendants) are providing more hands-on care to persons with dementia living at home. Yet, little is known about how family caregivers engage with paid caregivers. We conducted in-depth, semi-structured interviews ( = 15) with family caregivers, of persons living at home with severe dementia, and enriched our findings with data from a second cohort of family caregivers of persons with dementia ( = 9). Whether paid caregivers were hired privately or employed via a Medicaid-funded agency, family caregivers reported that they needed to manage paid caregivers in the home. Core management tasks were day-to-day monitoring and relationship building with family caregivers; training paid caregivers and coordinating care with homecare agencies was also described. In order to support family caregivers of individuals with dementia at home, it is important consider their preferences and skills in order to effectively manage paid caregivers. Support of efforts to build a high-quality paid caregiving workforce has the potential to improve not only care delivered to persons with dementia, but the experiences of their family caregivers.
随着美国长期护理的重心从机构向社区转移，有偿护理人员（即家庭健康助手、个人护理服务员）正在为在家中患有痴呆症的人提供更多的护理。然而，对于家庭护理人员如何与有偿护理人员合作，我们知之甚少。我们对 15 名与严重痴呆症患者一起生活在家中的家庭护理人员进行了深入的半结构化访谈，并通过第二组痴呆症患者的家庭护理人员的数据（= 9）丰富了我们的发现。无论有偿护理人员是通过私人雇佣还是通过医疗补助资助的机构雇佣，家庭护理人员都报告说，他们需要在家中管理有偿护理人员。核心管理任务是对家庭护理人员进行日常监督和建立关系；还描述了对有偿护理人员进行培训以及与家庭护理机构协调护理的情况。为了支持在家中照顾痴呆症患者的家庭护理人员，重要的是要考虑他们在管理有偿护理人员方面的偏好和技能。支持建立高质量有偿护理人员队伍的努力有可能不仅改善向痴呆症患者提供的护理，还改善其家庭护理人员的体验。
